Case study: Innovating dialysis and kidney failure treatment

Gaps in kidney failure treatment

While kidney disease is a leading cause of death and disability around the world, it is a vastly under-recognised health problem. Our research, published in The Lancet, has shown that each year, over 2.5 million people receive renal replacement therapy (dialysis or kidney transplant), yet double that number of patients need this lifesaving treatment.

While prevention measures are an essential factor in reducing the prevalence of kidney disease, the research highlights that there are now, and will continue to be, many millions of people who need dialysis but are unable to access it because of the associated costs. Sadly, most of these deaths are preventable and the biggest burden lies in low-to middle-income countries where less than a quarter of people who need dialysis are actually receiving it.

Executive Director of The George Institute, Australia, Professor Vlado Perkovic says the findings present a grim picture of the prevalence of kidney failure. “This could get worse—over coming decades, kidney failure rates are projected to grow rapidly and millions of people appear doomed to die without access to dialysis without specific action, with Asia being hit the hardest,” Professor Perkovic said. “ We urgently need to find ways to get people the treatment they need by making dialysis affordable, and by implementing preventative measures so fewer people develop kidney failure in the first place.”

Improving dialysis

Dialysis machines purify the blood, replacing an essential function of the kidneys, and can cost upwards of US $10,000, in addition to hospital and out-of-work costs associated with the illness. Additionally, dialysis machines require an elaborate water purification system which can often cost the same again.

“Treatment of kidney failure with dialysis has been around for half a century, yet the technology hasn't evolved substantively, remaining hugely expensive despite its simplicity,” explains Professor John Knight of The George Institute, Australia. “Computers have shrunk from the size of buildings to that of a watch in this time; that’s the kind of radical overhaul needed.”

The world urgently needs an affordable dialysis machine, one that runs on solar power and can easily purify and use water from any source. Sponsored by The George Institute, the International Society of Nephrology and the Asian Pacific Society of Nephrology with support from the Farrell Family Foundation, the Affordable Dialysis Prize awarded a US $100,000 prize to the person who designed the most resource efficient, cost-effective machine. The winning design, by UK engineer Vincent Garvey and announced in March 2016, is so compact it can fit into a small suitcase, and uses a standard solar panel to power a highly efficient, miniature distiller capable of producing pure water from any source.